Sara Reardon, aka The Vagina Whisperer, talks what's normal and what’s cause for concern when it comes to vaginas.

“I didn't know there was a physical therapy for THAT!”

This is one of the most common responses I get when I tell people what I do. I am a pelvic floor physical therapist. Physical therapists treat muscles and tissues and nerves in the body. I specialize in treating the muscles and tissues in the pelvic region of the body, which play an important role in peeing, pooping, supporting your organs, having sex, and birthing a baby.

The pelvic floor muscles sit like a basket at the base of your pelvis. These muscles stay contracted throughout the day to support your organs and hold in pee and poop. When you go to the restroom, you can relax these muscles to empty your bladder or bowels. Relaxation of these muscles is also essential for vaginal intercourse and childbirth.

Often, you won’t have to think about these muscles if all is working well. But just like any other muscle in your body, the pelvic floor muscles can get tense, weak, or not coordinate properly, which can lead to bladder or bowel problems or pain.

If your pelvic floor muscles are tense, you may experience vaginal pain, tailbone pain, painful intercourse, or incomplete emptying of your bladder and bowels. If your pelvic floor muscles are too weak, you may experience urinary leakage, decreased support of your pelvic organs, heaviness, pressure, or extreme urgency to get to the bathroom in time.

Pelvic floor issues may start after a significant event like pregnancy or childbirth, menopause, or starting a new activity or medication. Or they may happen gradually over time and you may believe them to be normal until they get to the point where they significantly affect your life. Some women may think little leaks with laughing or sneezing are normal, or that sex after childbirth is supposed to be painful, or we just have new bodies after having babies and nothing can be done about it. Although common, these are not normal experiences.  

Enter pelvic floor physical therapy. (Actually, it should enter much sooner than this.). In a pelvic floor physical therapy session, the therapist will gather some information and perform an assessment by checking posture, pelvic alignment, and the abdominal wall for tenderness, diastasis recti/abdominal separation, or scar tissue restriction. Then an internal muscle assessment through the vagina to check strength, tone, and tension of the pelvic floor will be performed — similar to a gynecologist appointment. After the assessment, the therapist and you will chat about what was found, give you some tips and exercises, and will plan a follow-up.

Pelvic floor physical therapists do not just treat pelvic floor conditions, we also work with patients on how to prevent them. Physical therapists spend a lot of time on education addressing topics that are rarely discussed, yet are so important to our daily lives: the proper way to poop, sex, leaking when sneezing, kegels aren’t for everyone, and teaching pregnant women how to push properly during childbirth and offering guidance on postpartum recovery.

We learn very little about pelvic health and prevention of pelvic floor problems from other women. Outside of “do your kegels,” these issues are just not talked about, leading one to think that the only options are medication, surgery, or “just dealing with it.” Pelvic floor physical therapy is an option to help treat these common conditions.

My goal as an advocate of women’s health reform and as a pelvic floor physical therapist is to change the way we care for women (and their vaginas). Talking openly about these issues is not about shock value. It’s about making sure we’re aware of issues that are addressable, and that when addressed can help us live fuller, happier, and more productive lives.


Dr. Sara Reardon is a physical therapist and a board-certified women’s health clinical specialist. She is the owner of NOLA Pelvic Health, a pelvic floor physical therapy clinic in New Orleans; thevagwhisperer.com.

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